Becker’s Nevus, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Becker's Nevus, Diagnosis and Treatment and Related DiseasesLast week a medical student came to see me for the removal of stitches for a punch biopsy done by his skin specialist in his university in Adelaide, Australia. He has scattered hyper-pigmented rash through his back and front of chest for the past 4 months. In spite of treatment the rash had not improved so the skin specialist decided to do a punch biopsy for histological examination under the microscope.
He was informed that the rashes were a form of Becker's nevus which normally has overgrowth of hair but because he was an asian and devoid of hair on the chest and back, there was no overgrowth of hair on his body. Treatment is normally by the use of laser to remove the disfiguring rashes. Becker's Nevus is regarded as a pigmented hamartoma of skin (benign, focal malformation); a hamartoma is a developmental anomaly occurring in childhood.
The term, Becker's nevus, is actually wrongly named because it is is not a true nevo-melanocytic lesion. Becker's Nevus produces:1. Abnormal skin discoloration, 2. Abnormal hair growth, and3. Thickening of skin (verrucous skin surface)It is a rare disorder that mostly affects males. Becker's Nevus occurs during one's childhood or adolescent stage and the skin lesions are mostly seen on the shoulders and backBecker's Nevus may manifest significant complications, such as acne or cosmetic disorders.
Sometimes, melanoma (a type of skin cancer) is known to form from this skin lesionBecker's Nevus is known to happen periodically and the cause is largely not knownThis disorder is not congenital (not evident at birth). All racial and ethnic groups are at risk and there is no specific preference observedBoth males and females are involved, though the frequency of Becker's Nevus is much higher in males compared to females.
The male-to-female ratio derived from documented cases is about 6:1. CauseThe cause of Becker's Nevus formation is not knownGenetic mutations (or genetic defects) have been suspected by doctors in some patients, but these have not been well-featuredIt is a hamartoma of ectodermal and mesodermal offshoots that is believed to be hormonally reactive given the augmented smooth muscle and peri-pubertal growth.
Androgen receptor assays have shown marked rises in the number of androgen receptors in lesional skin when compared with contra-lateral non-lesional skin. The increased presence supporting increased sensitivity to androgens is the findings of:1. Hypertrichosis, 2. Acanthosis, 3. Dermal thickening, 4. Sebaceous hypertrophy and5. Co-localized acne. Symptoms:1. It is a benign disorder that happens as a growth abnormality2.
Abnormally hyper pigmented skin is present.3. There is also the presence of a thickened skin and unusual hair overgrowth at the site4. The skin lesion may be painless and non-itchy5. Becker's Nevus can happen anywhere on the body. DiagnosisA Becker's Nevus is diagnosed through these tools:1. Complete medical history with a proper physical examination2. Dermoscopy: A dermoscope is a diagnostic tool where a dermatologist examines the skin using a special magnified lens3.
Wood's lamp examination4. Skin biopsy:Treatment1. The doctor may select to regularly observe the benign tumor; a "wait and watch" approach may be followed. No treatment is normally required2. If required, a surgical excision (or laser therapy) and complete removal of the lesion3. If there is Becker's Nevus linked acne, then treatment therapy for acne may be indicated4. Laser therapy may also be indicated for hyper-pigmentation and hyper-trichosisTABLE OF CONTENTIntroductionChapter 1 Becker's NevusChapter 2 CausesChapter 3 SymptomsChapter 4 Diagnosis...